05-0982 (RPL)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
Application Number . . .
Property Address . .
APN:
Application description
Property Zoning . . . . .
Application valuation . .
Owner
BUILDING PERMIT
. -p5-00000982 Date 3/17/05
80395 CAMARILLO WY
772-250-997-120 -31349 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
18000
TOLL CA V
C/O KEVIN D DUERMIT
8901 E MOUNTAIN VIEW 200
SCOTTSDALE AZ 85258
Contractor
CALIFORNIA POOLS & SPAS
P -.O. BOX 1280
COACHELLA CA 92236
(760) 398-9222
WCC: SEABRIGHT INS
WC: BB1050510 01/01/06
CSLB: 656128 10/31/06
CCC: C8 -C27 -C29-053
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Permit . . . . . . BLDG POOL PERMIT
Additional desc . .
Permit Fee . . . . 189.00 Plan Check Fee 122.85
Issue Date . . . . Valuation . . . . 17920
Qty Unit Charge Per Extension
BASE FEE 45.00
16.00 9.0000 THOU BLDG 2,001-25,000 144.00
-----------------------------------------------------------------------------
Permit . . . . . . MECH POOL
Additional desc .
Permit Fee . . . . 24.00 Plan Check Fee 6.00
Issue Date Valuation . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 9.0000 EA MECH FURNACE <=100K 9.00
-----------.-----------------------------------------------------------------
Permit . . . . . . ELEC POOL PERMIT -RES .
Additional desc
Permit Fee . . 45.00 P
Issue Date . . . . V
Qty Unit Charge Per
BASE FEE
1.00 30.0000 EA ELEC PRIVATE
---------------------------------------=------
Permit . . . . . . PLUMBING
Additional desc
I em e
MAR 21 2005
W F OWNTA
- - - --RNANCE CERT. - -
11.25
0
Extension
15.00
30.00
e
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLS TANIPIC0 a" FAX (760) 777-701 l
Tedf
4
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: P91 Date:
Applicant: Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under,penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Cgde. and my Lice is force and effect. 1,S6/ g,
t, license Class ' ens No. ---16 Z
C1e 2�LIZOr Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U I, as owner of the property. or my employees with wages as their sole compensation, will do the work. and the structure is not intended or offered for sale (Sec. 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an ownerof property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees. provided that the improvements are not intended or offered for sale. It. however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.).
U I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
L) I am exempt under Sec. . BA P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations.
1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have a d will maim workers' compensation insurance. as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
is ,AAy wor s' compensation insurance carr D V/11"C ,Qy _ tee{
arner �y Polic Numb iL�CiCJ!/
— I certify that, in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree at, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall
forthwith comply with those provisions.
✓"� G �!� A ,plicantr
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ, C.).
Lender's Name
Lender's Address IV
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application. the owner, and the applicant, each agrees to. and shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any:permit issued as a result of this application becomes null and void if work is not commenced within 180 days. from date of issuance of such permit. or
cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is co ct. agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby,authorize representatives of this count o er upon t b e -mentioned property for inspection purposes.
Date �/ [ �S Signature (Applicant or Agent).
Page
2
Application Number . . . . . 05-00000982 Date
3/17/05
Permit Fee . . . . 33.00 Plan Check Fee . .
8.25
Issue Date . . . Valuation . . . .
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 6.0000 EA PLB FIXTURE
12.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
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Permit . . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 15.00 Plan Check Fee
.00
Issue Date . . . . Valuation
80
Qty Unit Charge Per
Extension
BASE FEE
15.00
--------------------------------------=-------------------------------------
Special Notes and Comments
POOL & SPA. 5 L.F. 4' BLOCK WALL, CITY
STANDARD. ALARMS/BARRIERS SHALL BE IN
PLACE PRIOR TO PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED IN
PERMIT.
Fee summary Charged
----------------- ----------
Permit Fee Total 306.00
Plan Check Total 148.35
Grand Total 454.35
Paid Credited I Due
---------- ---------- ----------
.00 .00 306.00
.00 .00 148.35
.00 .00 454.35
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SPECIFICATIONS
SURFACE AREA of
QD
PfA11iETTR OfPTFfS WN, MA7I. r!
SPA PECI F AfjoN TILE - °?
xE x SCL Fr.
SPA DAM WALL WIDTH ,� f 771E WATM tME
NCK OF JETS x ZIP � �TlLij
RAISES SPI, AT
SPILLWAY TYPE
xw U LN P
SPECIAL NOTES IK V11F eyfa 6imco La
EXCAVI� 5T L sc, <
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ACCES5 MOM E msA ON dIOWFTs + ba
u � 0 CL3
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SW RV#vu LOOM
saps
rREF REMOVAL BY � M FACE
IF R}CATIQN R WovAt e17 — � ' ' — — TILE BASE _
LMK1 ATM: REPAIR ""'"`w SAM AW VQO�EM
s' R-BI.6. _
• �aaoNs
TV R.Fla Y[rW SFkTP
R.8_9, _ f{
TAN SHELF MlrT
RoarPOCX� fvfASOIY �Jt
CENTERS * �� WRNG TYPE
SPILLWAY . I WE
PLUMBlf+l
PR"-.EXT. WAurs
POOL PUMP �� SZE LL
Pt11N1Qi WA
9aosTFR PUMP
UMJ RETAIMING WAM "� +^
ACVL PP —� s E �- #
AOO'L PUWFI I _
HEAT ER �
TIME CLD
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S1U4s � JCFiS ?� '���w.L•
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fOuNrAlrais/RATIIrws
KILLED Omxq
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uQiTS IN r4 SFA ,i FTE]dALLS — --
STUB SET E — FEfVCffC --
wisc,
PtE+I.aOiG WE �. FF3 % rff _ ^^^��• _
HEWT "' CIO
CATE 6=0@Fmdm P
UATE FEVERtAL
CEP w RAW — � R V-10CIVE d< REHPM —
MENPED Ind S7EP
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SPBIYIAY TM �I3 { � ; i��?` 'EST- RTAFiT
CANTII,i:+� {rt 7'ST.'�`BRrspLeIlij�i
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R-6.6 - SEE STEf>
GWNM To; (T) DETE"INE THE APPRO)WTE EXYATION OF POOL N SPA AT LAYOUT DN DAY Of EXCAVATION
{2) TAKE NO2M 7NAT POM ANO E#JIPI,IENT UDCATIMS All 5J� TO A TAHCE OF
�
LOCAL BIJJLDING aEirAATkNT kS TBIE OF ISSUANCE OF PERWT
(a) WT °%*N CONCRETE SNEiL AT LEAST TMq DA4 Ly Fo SEVEN DAYS AFTER SHELL IS INWALLM
(4) AGR2
E: 7-HAT (AJFT'iWA POOLS IS NOT RMN*5�5U FOR UNDERMMMD COND1716Oft WXuC
,
AND ANY LIAiAOE 18 G 1R9£ SIPEI►ALIGS usrsEwAY, LAWS, OR OTHER 1TEWS IN THE AC= AREA
() THAT ALL FTC CAIM ANQ CARASE DOE7lRfi MEET U- r L COQES FM
A POOL fNCLOSUAE
PPUOR TO PREP`_A'S_f R MPEnOI
{sj FILL PGCL &YES71ATl;LY AFTER PLASTER. (FOLLOW NSTRSPCTIUNS — DO NOT {15E RUMM MOSS}
(7) THE
H0110E THAT PM5 DRAMN£, IS 1HE SOLE PROPERTY OF OAUFORWIA PXX$ ANp THAT ANY
USE M'H4UT VAlTTEIF PEf?M"gSlDN OF CAUFlORMA FOOLS, INC. iS PROHIRTEfl BY LAW_
I
MRN *PROVU FLAN, pDoj, AND EBUI"NT LOCATIONS AND HAS i{f C THE �.�OMSI6V0rrE5 AlIO NOTM ARC4E
Q
SICNATURE(S) ffA
__- - �fMING POOL PLAN FOR:
F I— ! {5'I }
NAME LV1�DI�4!'r Lf� AN
RESIDENCE
JOB ADQf�S �`a r� -
+.
PHONE OFFICE RES
LOT a TRACT' PACE Dppf{
1AP aow I -ACE NO. CITY
MAIL ADDRESS
CONSTRUCTION C r FICE IPLJONE NO-
SCALf� PATE DRAWN BY SOLD f3 CHECKED BY
REE�i
DATE
RtALDINC & SAFETY DEPT.
Lu
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COS!STRUCTION
t�
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CC
SELECTIONS
0
O I V R U `` N AUTHORIZATJON
STONE
DIG
BOULDERS
PRF=-Gl'4ITF:
DECK COLOR � ��-�- ri ,T- �
MASONRY
PE6f3. PLAS W
DECK
iNATURE
_F
P1 L,� 1?)f3F3l.E
DRAINAGE NOTE: Drcinlcge end piantefs ❑nd pots, by
others unfeuu otherwise notes.